Topic Contents

Abnormal Pap Test

Topic Overview

What is an abnormal Pap test?

When your
doctor says that your Pap test, or Pap smear, was abnormal, it means that the test found
some cells on your cervix that do not look normal.

A Pap test may be done as part of a woman's routine physical exam, because it's the best way to prevent cervical cancer. But having an abnormal test result doesn't mean you
have cancer. In fact, the chances that you have cancer are very small.

What causes an abnormal Pap test?

Usually these cell changes go away on their own. But certain types of HPV have been linked to
cervical cancer. That's why regular Pap tests are so important.

Sometimes the changed cells are due to other types of infection,
such as those caused by bacteria or yeast. These infections can
be treated.

In women who have been through menopause, a Pap test may find cell
changes that are just the result of getting older.

What increases your risk for an abnormal Pap test?

Certain sexual behaviors, like having sex without condoms and having more
than one sex partner (or having a sex partner who has other partners), can increase your risk for getting HPV. And HPV raises your risk for having an abnormal pap test.

HPV can stay in your body for many years without your knowing it. So even
if you now have just one partner and practice safer sex, you could still have an
abnormal Pap test if you were exposed to HPV in the past.

Do abnormal cell changes cause symptoms?

If a different sexually transmitted infection is the cause of your abnormal test, you may have symptoms such as:

A discharge from the vagina that isn't normal
for you, such as a change in the amount, color, odor, or texture.

Pain, burning, or itching in your pelvic or genital area when you
urinate or have sex.

Sores, lumps, blisters, rashes, or warts on
or around your genitals.

What will you need to do if you have an abnormal Pap test?

You may need more tests to find out if you have an
infection or to find out how severe the cell changes are. For example, you may need:

Colposcopy, a
test to look at the vagina and cervix through a lighted magnifying tool.

An HPV test. Like a Pap test, an HPV test is done on a sample of
cells taken from the cervix.

Another Pap test in about 6 to 12
months.

A colposcopy is usually done before any treatment is
given. During a colposcopy, the doctor also takes a small sample of tissue from
the cervix so that it can be looked at under a microscope. This is called a
biopsy.

Treatment, if any, will depend on whether your abnormal
cell changes are mild, moderate, or severe. In moderate to severe cases, you
may have treatment to destroy or remove the abnormal cells.

Cause

Other types of
infection—such as those caused by bacteria, yeast, or protozoa
(Trichomonas)—sometimes lead to minor changes on a Pap
test called atypical squamous cells.

Natural cell changes that may happen during and after menopause can also cause an abnormal Pap test.

What increases your risk of having an abnormal test result?

Certain sexual behaviors—such as having sex without condoms and having more
than one sex partner—increase your risk of getting an HPV infection. And an HPV infection raises your risk for having abnormal test results.

Other
things that may also play a role in increasing your risk include:

Having been exposed to
the drug DES while your mother was pregnant with you, though this is
rare.

If you have had one abnormal Pap test result, you're more likely to have another in the future.

Types of Results

Lab specialists label abnormal cells according to how abnormal they are—how different they are from normal cells. Knowing what type of abnormal cells you have helps your doctor decide on treatment.

Minor cell changes

Minor cell changes may disappear without treatment. But sometimes they turn into more serious cell changes. Types of minor cell changes are:

ASC-US or ASC-H. These are changes for which the cause is unknown. ASC-US changes usually stay the same or return to normal. ASC-H changes are also minor but have a higher likelihood of becoming more serious.

LSIL. These changes may be more likely to become more severe over
time, but even when they do, they usually return to normal.

For
cervical cancer, treatment will focus on destroying or
removing the cancer. To learn more, see the topic
Cervical Cancer.

A
pregnant woman with an abnormal Pap test is monitored
closely throughout her pregnancy. Monitoring may include a
colposcopy. The goal is to rule out
cervical cancer, a rare diagnosis. If cancer is ruled out, treatment for abnormal cell changes is done after delivery.

Other Places To Get Help

Organizations

American Congress of Obstetricians and Gynecologists
(ACOG)

www.acog.org

NIH: National Cancer Institute (U.S.)

www.cancer.gov (or https://livehelp.cancer.gov/app/chat/chat_launch for live help online)

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